The Speeds test is used to detect the pathology of the biceps tendon and assess for biceps pathology (like in biceps tendinopathy) as well as SLAP lesions in the shoulder. It is performed with the patient’s arm extended in full supination with the shoulder flexed. In this position, the patient is asked to elevate the arm against a resisted isometric force applied by the examiner.
To perform the Speed’s Test, the examiner places the patient’s arm in shoulder flexion, external rotation, full elbow extension, and forearm supination; manual resistance is then applied by the examiner in a downward direction. The test is considered to be positive if the pain in the bicipital tendon or bicipital groove is reproduced.
Speed’s test was originally designed to assess for the pathology of the long head of biceps in its groove but has also been utilized within the assessment for SLAP lesions.
Test
The patient’s elbow is extended, forearm supinated and therefore the humerus is elevated to 60°. The examiner resists humeral forward flexion.
Positive
Pain located to the bicipital groove. this is often commonly interpreted as implicational inflammation or lesions associated with the long head of the biceps or biceps/labral complex.
Bennett’s prospective study of all patients who presented with shoulder pain between Oct 1 sI 1994 – February 28 1995 correlated the clinical results of the Speed’s test with biceps/labral pathology by direct arthroscopic visualization.
46 shoulders in 45 patients were operated on during this point. Speed’s test was positive in 40 shoulders. Biceps/labral pathology was present in 10 of those patients.
He concluded that the Speed test may be a non-specific but sensitive test for macroscopic biceps/labral pathology. However, it’s positive with a various number of other shoulder pathologies.
| Specificity | Sensitivity | PPV | NPV |
| 13.8% | 90% | 23% | 83% |
References
SLAP Aprehension Test
